'It's a nightmare': informed consent in paediatric genome-wide sequencing. A qualitative expert interview study from Germany and Switzerland.

Autor: Eichinger J; Institute for Biomedical Ethics, University of Basel, Basel, Switzerland. johanna.eichinger@unibas.ch., Zimmermann B; Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.; Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany.; Institute of Philosophy & Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland., Elger B; Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.; Center for Legal Medicine (CURML), University of Geneva, Geneva, Switzerland., McLennan S; Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany., Filges I; Medical Genetics, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland.; Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland., Koné I; Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
Jazyk: angličtina
Zdroj: European journal of human genetics : EJHG [Eur J Hum Genet] 2023 Dec; Vol. 31 (12), pp. 1398-1406. Date of Electronic Publication: 2023 Sep 29.
DOI: 10.1038/s41431-023-01468-9
Abstrakt: The use of genome-wide sequencing (GWS) in paediatrics has added complexity to informed consent (IC) and pretest counselling because of the vast number and interpretation of potential findings, and their implications. However, empirical data from continental Europe on these issues remains limited. This study therefore aimed to explore the experiences and views of medical geneticists working with children in Germany and Switzerland regarding the challenges of obtaining valid IC in paediatric GWS. Qualitative interviews with 20 medical geneticists were analysed employing reflexive thematic analysis. In the interviews, many medical geneticists questioned the validity of parents' IC due to the enormous amount of relevant information given and the variety and complexity of the possible test outcomes. Key barriers identified included familial implications, administrative challenges and struggles with non-directiveness. Medical geneticists' suggestions for improvement included increasing the number of genetics professionals and better information material, which is crucial as GWS becomes a diagnostic standard in the early care pathways of children. An adjustment of aspirations from still existing ideal of traditional fully IC to appropriate IC seems to be needed. Such a more realistic and ethically sound adaptation of the requirements for IC can lead to better 'informedness' and improve the validity of the consent. This might also help reduce the moral distress for the medical geneticists involved.
(© 2023. The Author(s).)
Databáze: MEDLINE
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